Individual
MS. KATISHA EDNACOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1775 ALYSHEBA WAY, LEXINGTON, KY 40509-9023
(859) 639-1210
(859) 639-1211
Mailing address
1775 ALYSHEBA WAY STE 50, LEXINGTON, KY 40509-2479
(859) 639-1210
(859) 639-1211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA919
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95005864
—
KY
Enumeration date
10/24/2006
Last updated
11/05/2024
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